A palpitation is the feeling of an abnormal beat of the heart, the awareness of the heart beating. Usually, it is noticed in the chest and in the throat. Palpitations in sleep are not a rare occurrence.
There are numerous conditions that can cause palpitations while sleeping. They can happen in people free of cardiac diseases and in people suffering from cardiac diseases as well.
Following are mentioned the main causes of palpitations in sleep:
1. Dehydration- it can be due to the insufficient fluid drinking during the day or due to alcohol drinking. Exercising before sleeping can also cause dehydration
2. Eating improperly- eating large meals before bed is always bad for the health. It causes weight gain and palpitations amongst other issues.
3. The consumption of stimulants such as caffeine, nicotine and other drugs
4. Anxiety, stress, and depression- a troubled sleep due to anxiety, stress or depression almost always is source of heart palpitations
5. Hyperthyroidism- it is one of the most common causes of palpitations that last day and night.
6. Pregnancy- during pregnancy women can experience heart palpitations during the day when lying down and while sleeping.
7. Heart problems- heart problems are one of the most important causes of experiencing heart palpitations while sleeping. They can happen both in a heart with structural diseases and in a completely healthy heart.
a. In a healthy heart, palpitations usually occur during REM-phase (Rapid Eye Movement). While sleeping, a common occurrence in healthy hearts, are sinus bradycardia, sinus pauses and type 1 second-degree atrioventricular block.
b. In structurally damaged hearts ( congestive heart failure, valve affections, cardiomyopathy etc) palpitations occur usually between 5 and 6 am
8. Obstructive sleep apnoea- it is a common cause of palpitations in sleep in overweight men, whose have a large neck and sleep supine.
The aforementioned situations are the most common causes of palpitations while sleeping. There can also be other more rare situations that can cause sleep palpitations.
What is the mechanism?
The mechanism of heart palpitations in sleep varies depending on the cause.
1. Dehydration diminishes the circulatory volume. This leads to the decrease of the heart outflow. The decrease of the blood outflow and the lying position in which the body is found during sleep requires extra work from the heart in order to properly supply the tissues with blood.
It has to beat faster and harder, and this can cause heart palpitations.
2. Eating large meals before sleeping causes the heart to beat faster to pump blood to the intestines in order to digest the eaten foods.
3.The intake of caffeine, nicotine and other drugs directly stimulates the heart to beat faster. This causes palpitations, even more, when one is sleeping and the chances of perceiving the beating of the heart are high.
4. Anxiety, stress and depression stimulate the sympathetic system which, on the other side stimulates the heart to beat faster.
5. Hyperthyroidism is a state in which the thyroid hormones are at a higher level in the blood than they should be. Thyroid hormones are direct stimulants of the heart muscle by causing it to beat faster and harder. This causes palpitations at any time of the day including while sleeping.
6. Pregnant women experience often heart palpitations. This is due to the fact that the heart has to work harder in order to properly supply both the mother and the fetus with blood.
7. Heart palpitations in sleep in a completely healthy heart are due to the increased activity of the sympathetic system, which stimulates the heart to beat faster.
In structurally affected heart, palpitations are due to arrhythmias, or due to the decrease heart outflow.
An affected heart has decreased blood outflow, it has to work harder I order to overcome the difficulty in pumping blood throughout the body, even more, when one Is lying down because there is no gravity force to help the blood spread in the most distant parts of the body.
8.Obstructive sleep apnoea causes palpitations due to hypoxia. During apneic episodes, the collapsed pharynx does not allow one to breathe. The decrease of oxygen in the blood stimulates the heart to beat faster.
What can I do not to feel palpitations in sleep?
To prevent palpitations while sleeping, one must avoid the situations that cause these palpitations.
If they are caused from and underlying disease such as heart problems, thyroid affections, obstructive sleep apnoea, anxiety, stress, depression etc, consulting with a doctor to get the proper drug treatment is necessary.
But, when these palpitations happen in diseased free organism, they can be avoided if following these simple tips:
1. Drink at least 1.5-liter fluids a day (water and other non-alcoholic beverages)
2. Do not drink alcohol in high amounts
3. Do not exercise before sleep
4. Do not drink caffeine, nicotine or other drugs before sleep
5. Do not have large meals after 4 p.m
6. If suffering from anxiety, stress or depression consider exercising relaxing techniques before sleeping, such as yoga, breathing therapies etc.
Do not sleep on your left side in case of a heart problem, because in this position the heart would be pressed against the sternum and this would compromise its working.